Dependent Coverage to Age 30
If you have group health insurance from your
employer, chances are that your children will come off the Plan at age 19 or 23,
if a full-time student. Some carriers offer a rider that allows dependent
children to continue to age 26. If
your adult child ages-off the plan, he/she can still continue benefits under the
NJ Continuation Law for 36 months. However, there will be an additional option
to continue coverage to age 30, effective May 12th.
New Jersey has enacted a new Law that goes into effect on May
12, 2006. It allows for your
adult child (age 19 to 30) to stay on your group health insurance plan if he/she
meets the following criteria. The
child does not have to live with the parents but he/she must be a resident of
New Jersey, cannot be married, and cannot have any dependents. Lastly, they can not be eligible for any other group
coverage. For example, if they get
a job with health insurance benefits, they must go on that plan.
They cannot continue under the “Overage Child Law”.
Please note that “overage child law” is not the actual name of the
law. The actual name is P.L.
(Public Law) 2005, Chapter 375 “Continuation Coverage for Eligible Dependents
Until 30 Years of Age”. It
is referred to as the Overage Child Law. This
Law applies only to health insurance. It does not include dental coverage.
This
law pertains to all size insured groups with a New Jersey group health insurance
plan. Please note it must be a NJ
group health insurance plan. If you
work in NJ for a company headquartered in California, and you have a California
group health insurance plan, then this new law does not apply.
If
your adult child applies for this coverage, and then moves out of NJ, he/she
loses the coverage. If he/she
moves back to NJ at another time, still under 30 years of age, and still meeting
the other requirements described above he/she can apply for the coverage again.
The
parents or adult child are responsible for paying the premium.
As of this writing, the premium structure has not yet been announced by
any of the insurance carriers for this “new group” of eligible insureds.
First, it has to be approved by the Insurance Commissioner. These new
rates need to be available by May 12th.
The Department of Insurance is still in the process of developing rules
for implement this new Law and they will not be ready by May 12th,
when the Law goes into effect. There
has been some speculation that it may be less expensive for the adult child to
continue on the group health insurance plan under the NJ Continuation Law which
allows the adult child to stay on the plan for 36 months.
At that time, he/she can switch to the “Overage child” Law.
When
an overage child seeks continuation of coverage under Chapter 375 (this new
Law), the parents must be covered under the group plan at that time.
If an overage child is eligible for Medicare, he/she cannot get coverage
under Chapter 375.
Suffice
it to say, if the premium is not paid, coverage can and will be terminated.
As stated above, rules and regulations are still being written so we will
have additional information available at a later date.
Irene Card & Betsy Chandler are both licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.
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